CHAPTER X 



SUBACUTE OBSTRUCTION OF THE 



PELVIC FLEXURE OF THE 



DOUBLE COLON 



Definition. — So long as the full wording of this chapter 

 heading is adhered to, no definition will be needed. It 

 sufficiently explains itself. 



On reference to p. 8i it will be seen that the preceding 

 chapter is ' given over to all obstructions of a subacute 

 type that occur in any position in the large or double 

 colon.' No attempt is made there to indicate any special 

 seat of trouble, or to single out any particular portion of 

 the colon's course as calling for more than ordinary 

 mention. At the time when that was written — namely, 

 in 1902 — I did not feel that I had anything sufficiently 

 clear in the shape of a differential diagnosis to offer. 

 Nevertheless, it will be noticed that, even then, I 

 indicated, if only vaguely, that such might be furnished 

 by fuller investigation. 



Since that time, a record of several cases, together 

 with the evidence gathered during post-mortems of twist 

 of the double colon, has shown me that often we have a 

 form of obstruction mainly, if not entirely, confined to 

 the pelvic flexure of that bowel. It has shown me, too, 

 that quite often the condition may be diagnosed, and the 



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